Lupus-like glomerulonephritis: an autoimmune complication of hepatitis C infection

Hobeika, Liliane; Srivastava, Monica; Vo, Mai; Philipneri, Marie; Brink, David S.; Wasi, Nadia; Lentine, Krista L.

doi:10.1007/s13730-012-0008-3

CEN Case Rep

2012

DOI: 10.1007/s13730-012-0008-3

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Lupus-like glomerulonephritis: an autoimmune complication of hepatitis C infection

Liliane Hobeika

Monica Srivastava

Mai Vo

et al.

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Cited by 3 publications

References 27 publications

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Cyclophosphamide/interferon-α-2a

2013

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S Cyclophosphamide/interferon-α-2a Hypersensitivity and haematologic toxicities: case reportA 53-year-old man developed hypersensitivity during treatment with cyclophosphamide. During subsequent treatment with interferon-α-2a, he developed the following haematologic toxicities: thrombocytopenia and bleeding.The man, who had a chronic hepatitis C virus infection, presented with dialysis-requiring renal failure. He was diagnosed with lupus-like glomerulonephritis. Treatment included oral cyclophosphamide 150mg daily. After 2 weeks of treatment, he was switched to IV cyclophosphamide 500 mg/m 2 [frequency not stated]. Several days later, he developed daily spiking fevers. He also exhibited a mild transaminase elevation. Chronic hepatitis C stage IV (cirrhosis) was seen with a liver biopsy, and pan-cultures did not show signs of infection. Cyclophosphamide hypersensitivity was thought to be the cause of his fevers. He remained oliguric, with suspected treatment toxicity and without appreciable renal recovery.Cyclophosphamide was withdrawn. The man's transaminase elevation and fevers resolved. He was started on interferon-α-2a [dosage, route and duration of treatment to reaction onset not stated; indication not clearly stated], which was later withdrawn due to thrombocytopenia and bleeding. The thrombocytopenia and bleeding resolved, and he continued haemodialysis for over 18 months.

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Cyclophosphamide/interferon-α-2a

2013

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Systemic Lupus Erythematosus and Virus C Infection - Diagnosis, Evolution and Treatment Particularities

Rotariu

Penescu

2020

Internal Medicine

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Lupus erythematosus (SLE) is an autoimmune disease with a broad spectrum of clinical and immunologic manifestations. Hepatitis C virus (HCV) has been postulated as a potential etiologic or triggering agent among other viruses and it appears to be associated with the presence of autoimmune disorders, even mimicking SLE clinically and serologically. Data on the association between HCV infection and SLE are scarce, but an interaction between these two conditions seems possible. As for treatment options, it is well known that the classic antiviral therapy with interferon may aggravate preexisting autoimmunity, unmask previously silent autoimmune processes, or even cause the emergence of de novo autoimmune disease, including SLE. Interferon-free treatment seems to be more efficacious, safer and more tolerable. However, it is important that clinicians be aware that DAAs (direct acting antivirals) can also trigger lupus-like immune complex-mediated glomerulonephritis. There is scant data on the use of immunosuppressive drug therapy in HCV patients. It seems that enhanced HCV replication due to immunosuppression does not lead to clinically significant sequelae and growing evidence has been reported that supports its efficacy and safety. Patients with SLE and virus C infection are a special category, a fact that the clinician needs to take in consideration in order to a better approach, all the more as these patients are at increased risk for developing end-stage renal disease and have a lower survival rate than general population.

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A Case of Systemic Lupus Erythematosus with Renal Failure Following the Administration of Sinopharm COVID-19 Vaccine

Mahmudpour¹,

Nabipour²,

Esmailie³

et al. 2022

Iran South Med J

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Lupus-like glomerulonephritis: an autoimmune complication of hepatitis C infection

Cited by 3 publications

References 27 publications

Cyclophosphamide/interferon-α-2a

Cyclophosphamide/interferon-α-2a

Systemic Lupus Erythematosus and Virus C Infection - Diagnosis, Evolution and Treatment Particularities

A Case of Systemic Lupus Erythematosus with Renal Failure Following the Administration of Sinopharm COVID-19 Vaccine

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